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Anatomy term 2 > The Knee joint > Flashcards

The Knee joint Flashcards

1
Q

What are acute injuries to the knee caused by and where do they usually present to?

A
  • sports
  • falls
  • elderly
  • fracture
  • tear/sprain of ligaments
  • soft tissues
  • cartilage
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2
Q

What causes acute swelling/ pain?

A
  • atraumatic causes
  • acute gout
  • flare of Osteo-arthritis
  • flare of RA
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3
Q

What causes chronic knee pain/ swelling?

A
  • osteoarthritis

- bursitis

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4
Q

What can severe knee pain result in?

A

reduced mobility

poor sleep

reduced quality of life

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5
Q

How does chronic knee pain/swelling have to last for in order for it to be classified as chronic?

A

3-4 months to 1 year

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6
Q

What is not associated with the knee joint?

A

fibula

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7
Q

What type of joint is the knee joint?

A

hinge joint

synovial

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8
Q

What 3 bones are involved in the knee joint?

A
  1. distal femur
  2. proximal tibia
  3. patella
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9
Q

How many articulations do the 3 bones involved in the knee joint form?

A

3 articulations

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10
Q

What are the 3 articulations formed in the knee joint?

A
  • 2 femorotibial - medial and lateral

- 1 femoropatellar

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11
Q

What is the most proximal part of the tibia like?

A

flat

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12
Q

What are the movements of the knee joint?

A
  • extension/ flexion

- medial/lateral rotation - only a very small amount of rotation

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13
Q

Why do you lose knee flexion when the hip is extended?

A

due to the loss of tension on hamstrings

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14
Q

When can rotation occur?

A

when knee is flexed and collateral ligaments are relaxed

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15
Q

What happens when the knee joint approaches full extension?

A

the femur undergoes a few degrees of medial rotation on the tibia

this is also known as locking

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16
Q

What is locking?

A

joint approaching full extension and causing the femur to undergo a few degrees of medial rotation on the tibia

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17
Q

Is locking the knee stable or unstable and why is it so?

A

it is stable - as thigh muscles can relax

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18
Q

How is the knee unlocked?

A

By the popliteus muscle

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19
Q

What does the popliteus muscle do to the femur?

A

it laterally rotates the femur

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20
Q

Where and what is the popliteal fossa?

A

The space at the back of the knee

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21
Q

What runs through the popliteal fossa?

A

the popliteal artery

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22
Q

What are the medial and lateral femoral condyles?

A

expanded ends of the femur

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23
Q

What are the slight expansions of the proximal tibia?

A

medial and lateral tibial condyles

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24
Q

What is the flat surface of the tibia above the condyles known as?

A

tibial plateau - medial and lateral

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25
Q

What is the fit like of the tibial plateau with the rounded femoral condyles and what is the joint described as?

A

poor fit

incongruent

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26
Q

What is the tibial plateaux deepened by?

A
  • 2 plates of fibrocartilage

- the menisci

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27
Q

What is stability and congruency like in extension?

A

most stable

very congruent

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28
Q

What is stability and congruency like in flexion?

A

unstable

least congruent

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29
Q

What are the menisci?

A

2 c shaped wedges of fibrocartilage

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30
Q

Where are the menisci thicker?

A

at the external margins

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31
Q

What are the functions of the menisci?

A
  • increase joint congruency
  • distribute weight evenly
  • shock absorption
  • assist in locking mechanism
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32
Q

What do the external edges of the menisci attach to?

A

fibrous capsule of the joint

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33
Q

What is the medial meniscus firmly attached to?

A

the tibial collateral ligament

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34
Q

What can cause meniscal tears?

A

sports or degenerative changes

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35
Q

What can cause pain or locking in meniscal tears?

A

displaced cartilage becoming trapped during knee movements

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36
Q

What is the treatment of meniscal tears?

A

repair or resection

37
Q

What arthritis is damage of the meniscus associated with?

A

osetoarthritis

38
Q

Why is the meniscus not very good at repairing itself?

A

as there is decreased blood supply

39
Q

What are the different types of meniscal tears? (6)

A
  1. vertical
  2. transverse
  3. peripheral
  4. bucket handle
  5. parrot beak
  6. flap
40
Q

What contribute to the stability of the knee?

A

ligaments

muscles - surrounding (most important part of the knee)

41
Q

What are the ligaments inside the joint/ intra-articular ligaments?

A

anterior and posterior cruciate ligaments

42
Q

What are the ligaments outside the joint/ extra articular ligaments?

A

fibular and tibial collateral ligaments

they work down on each side of joint

43
Q

Where are the cruciate ligaments?

A

inside the joint capsule

44
Q

how do the cruciate ligaments cross each in the centre of the knee?

A

obliquely

45
Q

What does the posterior cruciate ligament attach to?

A

posterior intercondylar region of the tibia

46
Q

Where does the posterior cruciate ligament travel?

A

supero-anteriorly to insert onto the medial femoral condyle

47
Q

What does the anterior cruciate ligament attach to?

A

anterior intercondyle region of the tibia

48
Q

How does the anterior cruciate ligament travel?

A

supero-posteriorly to attach to the lateral femoral condyle

49
Q

Which is the stronger cruciate ligament?

A

Posterior cruciate ligament

50
Q

What does the posterior cruciate ligament prevent?

A

posterior displacement of the tibia of the femur

hyperflexion

51
Q

Which cruciate ligament is the main stabiliser of the flexed knee when weigh bearing?

A

posterior cruciate ligament

52
Q

How can the posterior cruciate ligament be damaged?

A

When landing on the tibial tuberosity with the knee flexed - tibia slides backwards

53
Q

What does the anterior cruciate ligament prevent?

A

anterior displacement of the tibia on the femur

hyperextension

54
Q

How can the anterior cruciate ligament be damaged? (2)

A

when knee is hyperextended to force is applied anteriorly

55
Q

Which cruciate ligament is more commonly injured?

A

anterior cruciate ligament

56
Q

What is the tibial/medial collateral ligament?

A

a flat band attached to the medial meniscus

57
Q

What does the tibial/medial collateral ligament prevent?

A

prevents abduction of the at the knee

58
Q

What is the fibular/ lateral collateral ligament?

A

cord like band not attached to the lateral meniscus

59
Q

What does the fibular/ lateral collateral ligament prevent?

A

prevents adduction of the leg at the knee

60
Q

How does the lateral and medial collateral ligaments provide stability to the knee?

A

they prevent rotation during extension

61
Q

What is a combined knee injury also known as?

A

the unhappy triad

62
Q

What is a combined knee injury caused by?

A

excessive lateral twisting of the flexed knee

blow to the lateral side of the extended knee

63
Q

What is torn in a combined knee injury?

A

tibial collateral ligament which is attached to the medial meniscus - which also tears

anterior cruciate ligament may also tear as it is taut during flexion (common when flexed knees are twisted)

64
Q

What muscles are important in relation to the knee joint and act as the main stabilisers of the knee? (5)

A
  1. quadriceps
  2. hamstrings - posterior thigh
  3. sartorius
  4. gracillis
  5. illiotibial tract
65
Q

What can compensate for ligament damage and avoid surgery?

A

building up quads through physio and exercise - cycling

66
Q

What are two bursae you need to be aware of?

A

prepatellar bursa

suprapatellar bursa

67
Q

What problems can occur with the bursae and who is more prone to getting them?

A
  1. prepatellar bursitis
  2. suprapatellar effusion

people who spend a lot of time on their knees

68
Q

What are common bony fractures to the knee? (3)

A

Fractures to:

  1. patella
  2. tibia
  3. distal femur
69
Q

What and where are the causes of the common bony fractures to the knee?

A
  • trauma
  • osteoporotic bone - low energy fractures
  • peri-prosthetic - fractures around joint replacements
70
Q

What are common meniscal tear causes?

A
  1. acute injury/ trauma

2. wear and tear

71
Q

What are causes of ligamentous injuries to the knee?

A
  • trauma
72
Q

What injuries usually happen to the ligaments of the knee?

A
  • tears and rupture
73
Q

What are common dislocations?

A
  • patella - more common in females
  • whole knee joint - very uncommon
  • acute injury/ trauma
74
Q

What direction do patella dislocations occur?

A

laterally due to placement and alignment of the knee

75
Q

What direction does the rectus femurs, vastus intermedius and vast us lateralis pull?

A

superolaterally

76
Q

What are the rectus femurs, vast us intermedius and vastus lateralis counteracted by?

A

the horizontal pull of the vast us medial is

77
Q

Why is patella dislocation more common in females?

A

ankle of the neck of the femur is different and therefore the angle of placement is bigger (Q angle)

78
Q

What is the dislocation of the patella related to?

A

the alignment of the femur in relation to the tibia

79
Q

What are examples of abnormal alignment of the femur in relation to the tibia?

A
  1. genu varum

2. genu algum

80
Q

What is genu varum?

A

tibia is adducted wither respect to femur - bow leg

81
Q

What is genu valgum?

A

Tibia abducted with respect to femur

82
Q

What changes are apparent in osteoarthritis?

A
  • osetophytes
  • scleorosis - abnormal density of bone
  • reduced joint space - very little meniscus
83
Q

What does abnormal alignment of the knee lead to?

A

abnormal loading around the knee

84
Q

What is a characteristic feature of a patellar fracture?

A

rough jagged ends

85
Q

What shouldn’t you confuse a patellar fracture with?

A

bi-partite patellar - no jagged ends

86
Q

What is a characteristic of a femoral fracture?

A

painful - shards of bone

87
Q

How much force is required for a tibial plateau fracture?

A
  • a lot

- can be subtle and can be easily missed

88
Q

What tears in a complete knee dislocation?

A

cruciate ligaments - connecting the tibia to the femur

89
Q

What would you worry about in complete knee dislocation?

A

damage to blood supply and nerve supply (popliteal artery and nerve)

Anatomy term 2 (25 decks)

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